MSF warns of imminent health disaster in camps

More funding is urgently needed to avert a looming health catastrophe in Kenya’s Dadaab refugee camps, warns international medical organisation Médecins Sans Frontières/Doctors Without Borders (MSF) today. A cholera outbreak in the camps has affected 2,786 people so far and there is an imminent risk of outbreaks of other gastro-intestinal diseases, warns MSF, which is calling for immediate action from donors and aid agencies to address the unsanitary conditions and overcrowding in the camps. 

The three refugee camps which make up the Dadaab complex, located in Kenya’s north-eastern region, are home to over 300,000 refugees, most from neighbouring Somalia. Their population has grown rapidly in recent months due to an extended drought in Somalia, leading to severe overcrowding and increased pressure on existing services, including supplies of drinking water and latrines.

“The gravity of the situation demands urgent attention, particularly in the areas of water, sanitation and hygiene,” says Hassan Maiyaki, MSF country director in Kenya. “We have already seen the worst cholera outbreak in five years and the risk of other epidemics breaking out is high. If this occurs, it would outstrip medical capacity in the camps, with potentially catastrophic consequences.” 

The current cholera outbreak is linked to reductions in essential water and sanitation activities in the camps, including providing clean water, distributing soap, constructing and repairing latrines, and organising waste management. Today, according to humanitarian organisations working in the camps, almost half the camps’ population have no access to functional latrines, leading to open defecation in and around the camps, which raises the risk of disease outbreaks.

The Kenya ministry of health and humanitarian agencies carried out cholera vaccinations and health promotion campaigns to help people protect themselves from the disease, but curbing the outbreak will require improvements to water and sanitation infrastructure.

“Despite our health promotion activities and vaccination campaign, controlling this cholera outbreak remains elusive without the prioritisation of resources towards sustained preventive water, sanitation and hygiene interventions,” says Dr Nitya Udayraj, MSF medical coordinator in Kenya. “If they are not improved in quality and scale, it is just a matter of time before we see other epidemics erupt in the camps such as Hepatitis E.”

MSF runs a hospital in Dagahaley, one of the three camps that make up Dadaab. In Dagahaley alone, MSF teams have reported more than 1,120 cases of cholera and two deaths since the start of the outbreak in November 2022. 

MSF water and sanitation teams are currently trucking 50,000 litres of drinking water each day to the outskirts. In recent weeks they have built 150 communal latrines, both within the camps and on the outskirts, where around 9,000 newly arrived refugees have set up rudimentary shelters in the surrounding desert. So far, MSF has provided around 1,000 of these households with plastic sheeting, mats and liquid soap. But much more needs to be done to meet people’s needs and prevent a humanitarian crisis. 

The Kenyan government has announced plans to reopen a fourth camp – Ifo 2 – to accommodate new arrivals and alleviate the strain on resources in the existing camps. MSF is calling for these plans to be enacted as a matter of urgency, and to include increased funding for water and sanitation across all four camps. 

“The relocation to Ifo 2 should be hastened to ease pressure on the existing camps,” says Maiyaki. “All efforts to ease the overcrowding must include significant investment in the water, sanitation and hygiene sector to ensure a minimum standard of living for refugees in all the camps.” 

MSF calls on the international community, donors and aid agencies to respond urgently to the unfolding crisis in Dadaab, taking immediate action to address the alarming sanitary conditions and prevent the further spread of disease. In the longer term, MSF calls on the Government of Kenya and the UNHCR to find durable solutions for the refugees confined within the camps at Dadaab. 
 
The three camps of Dagahaley, Ifo and Hagadera currently host more than 245,000 registered refugees, many of whom have lived in the camps for more than three decades. The camps also host more than 124,000 unregistered refugees, including 67,000 who arrived in 2022. 

In January, MSF set up two more health clinics to provide healthcare to newly arrived refugees on the outskirts of Dagahaley camp. MSF has been providing medical care in and around Dadaab for most of the camp’s 32-year existence. Currently MSF’s activities are focused in Dagahaley camp, where its teams provide comprehensive healthcare to refugees and host communities through two health posts and a 92-bed hospital. As well as general healthcare, MSF teams provide sexual and reproductive healthcare including emergency obstetrical surgery, medical and psychological assistance for survivors of sexual violence, mental healthcare, home-based insulin care and palliative care.